Individual
SHIRLEY R HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1222 LUKE STATION RD, BLAKELY, GA 39823-6010
(229) 308-0598
Mailing address
1222 LUKE STATION RD, BLAKELY, GA 39823-6010
(229) 308-0598
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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